Older People: Their Place and Contribution in Society
The Archbishop of Canterbury: My Lords, I am most grateful for the opportunity afforded to raise the pressing and still largely ignored question of the well-being of older citizens in our country. I doubt very much whether, in your Lordships’ House, I need to underline the fact that those over, say, 62 are readily capable of making a contribution to society. I think that we may take as read declarations of personal interest in this regard; though I must also declare a specific interest as a patron or vice-president of practically all the voluntary agencies I shall be mentioning in the course of thesen remarks. Yet the fundamental issue which has prompted this debate is the undoubted fact that we are becoming dangerously used to speaking and thinking of an ageing population as a problem, a burden on public purse and private resources alike. My hope for this debate is not so much to strengthen support for particular initiatives, although I shall be mentioning some, as to plead for a change in attitude that will appropriately recognise the dignity of older citizens, whatever their condition.
As things stand, more than half the over-60 population are involved in some sort of formal and structured voluntary work; over half the population in general believe that this is part of what they should aspire to in later life; and a third of the population declare themselves willing to take part in informal volunteering. These facts are of basic importance. They mean, quite simply, that a majority of the older population are ready to do what they can, unpaid, to support the fabric of society; in other words, people are doing exactly what we expect responsible citizens to do. And a majority of us see this as a goal for our own later years. A conservative estimate of the value of the voluntary work already done in caring and family maintenance alone by the over-60s is in the region of £50 billion.
The first question we must address, therefore, is what can be done by government and other agencies to harness most effectively this resource, not just as a way of solving problems that require such resources, but as an affirmation of positive models of living for older citizens. If we live in a society that expects its older citizens to continue to support the fabric of their society and values them for doing so, we shall at least put to rest the damaging stereotype of older people as being essentially passive in relation to society at large. And that means in turn that we may stop seeing the older population as primarily “dependants” on the goodwill of family or neighbourhood or state. As we have seen, a majority of the population expect that there will be positive opportunities in their later years; we need to work with that perception and reinforce it strongly. The Equality Act 2010 has laid clear foundations in this respect, but more needs doing to build some solid embodiments of the principle. For example, we need to ask how businesses not only prepare employees for such a future, but how they foster a continuing relationship with older citizens in their own exercise of corporate responsibility. A vigorous dialogue between business and local advocacy groups is essential here.
It is only against such a background that we can usefully address the questions that do arise in relation to dependency, because it is of course a fact that advancing age is likely to decrease physical independence in various ways. But rather than taking this as the core issue, we should see questions of dependency as basically about how our public policy and resourcing seek to preserve both dignity and capacity among those who may be increasingly physically challenged, but who remain citizens capable of contributing vital things to the social fabric. There is a lot to learn in this regard from the work done by disability rights and advocacy groups. We must recognise that it is assumptions about the basically passive character of the older population that foster attitudes of contempt and exasperation, and ultimately create a climate in which abuse occurs.
Shockingly, Ruth Marks, the Older People’s Commissioner for Wales, estimates that one in four older people report one or another form of “elder abuse” ranging from patronising and impatient behaviour to actual physical mistreatment. In passing, it is worth considering whether the model of an older people’s commissioner is one that Wales might helpfully lend to other parts of the United Kingdom.
Delivering Dignity, the February 2012 report of the Commission on Dignity in Care for Older People, sets out a comprehensive picture of what older citizens have a right to expect in terms of care and respect, with far-reaching implications as to the training of professional carers and care managers in and out of the NHS. It recommends, for example, that the Government’s Nursing and Care Quality Forum should expand to include healthcare assistants and those working in care homes, and significantly, that the status of such care workers should be promoted by means of a “college of care”.
One of the less recognised results of a dismissive attitude to the needs of older citizens receiving care is a view of carers for the elderly as a sort of proletariat among health and care professionals. There is a vicious circle at work here that needs dismantling. It is worth mentioning that some hospices, such as the pioneering St Christopher’s, have blazed a trail in defining first-rate care standards. Needless to say, the same applies where we are talking about more than merely physical incapacity. Dementia and depression are painfully familiar challenges -I would guess that a good many in this Chamber have experience at first hand of caring for family members living with such conditions. The Alzheimer’s Society, in co-operation with the Prime Minister’s challenge on dementia, has an initiative aimed at creating dementia-friendly communities, and more needs to be done once again in challenging those attitudes that lead to stigma and increased isolation.
This returns us to the challenge of the commission’s report, which flags up the need for integrated care, drawing together home, hospital and care home. The commission recommends that hospitals perform a full assessment of older people’s care needs before they are discharged, with a named staff member taking ongoing responsibility for liaison with patient and family. Once again, many hospices have developed increasingly extensive and sophisticated ways of involving the wider community in their work, in a way that impacts constructively on general attitudes towards the older population.
All this also underlines the importance of the intergenerational relationship. As family structures become looser and more scattered geographically, it is vital that there be regular opportunities for interaction between younger and older people, not least between children and older citizens, whether through schools arranging visiting and befriending or through formal and informal oral history projects, which have been a very significant aspect of the life of some schools in creating and developing liaison with older members of the community. It is here, too, that the contribution of churches and faith communities may be particularly significant. In a good many contexts, these are simply the most robust and effective promoters of intergenerational contact and formal or informal volunteering opportunities for older people.
Much more could be said about specific questions and proposals. We have had two extremely important contributions in recent years to the overall policy landscape in the shape of the Dilnot report and the Delivering Dignity document, to which I have already referred more than once.
In conclusion, I return to the matter of attitudes to the elderly. A great deal of our culture is frenetically oriented towards youth-notably in entertainment and marketing. Up to a point, this is perfectly understandable: people want to put down markers for the future as they see it and to capture the attention of a rising generation. However, the effect of all this can be to ignore the present reality of responsible, active people in older life, who are still participants in society, not passengers. Its effect can also be to encourage younger people to forget that they are ageing themselves. To speak of an “ageing population” is, in one sense, simply to utter the most banal of all cliches, because ageing is something that we are all doing whether we like it or not. Younger people may forget that they are ageing themselves and will be in need of positive and hopeful models for their own later years. We tolerate a very eccentric view of the good life, or the ideal life, as one that can be lived only for a few years, say, between18 and 40. The “extremes” of human life-childhood and age, when we are not defined just by our productive capacity and so have time to absorb the reality around us in a different way-are often hard for our society to come to terms with. Too often, at the one end of the spectrum, we want to rush children into pseudo-adulthood; too often we want older citizens either to go on as part of the productive machine as long as possible or to accept a marginal and humiliating status, tolerated but not valued, while we look impatiently at our watches waiting for them to be “off our hands”.
The recovery of a full and rich sense of human dignity at every age and in every condition is an imperative if we are serious about the respect we universally owe each other-that respect which, for Christians, is grounded in the divine image discernible in old and young alike. I beg to move.